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Saint Mary’s University of Minnesota

Schools of Graduate and Professional Programs

Surgical Technology

Program

Student Handbook

Saint Mary’s University of Minnesota of Minnesota

Schools of Graduate and Professional Programs

Approved: University Academic Policies and Procedures Committee:

September, 2013

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Contents: Page Number

Table of Contents 2

Introduction 3

Faculty 4

Affiliation Information 5-6

Surgical Technology Program Outcomes 6

Surgical Technology Grading Standards 7

Surgical Technology Course Content and Course Descriptions 8-18

Surgical Technology Case Minimum Requirements 19-20

First and Second Scrub Role and Observation 20-21

Graduation Requirements 21-22

Academic and Clinical Evaluation Policies 22

Class and Clinical Attendance Policies 22-23

Homework Standards 23

Student Health Status Policy 23

Student Illness 24

Clinical Affiliation Sites 24

Student Work Policy 24

Student Behavior Policy 24-25

Unsafe and Unprofessional Clinical Practice Defined 25

Hazardous Material/Exposure to Blood or Body Fluids Policy 25-26

Student Health Insurance 26

Professional Liability Insurance 26

Criminal Background Studies 26

Certification in Basic Life Support (BLS) 26

Policy Concerning Unanticipated Patient Events/Outcomes 26

Supervision of Student Surgical Technologists 27

Parking/Transportation 27

Identification Badges 27

Dress Code 27

Semester Fee 27

Statement of Student Rights and Responsibilities 27-28

Forms

Hazardous Material/Exposure to Blood or Bodily Fluids 29

Student Performance Plan 30

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Introduction

Saint Mary’s University of Minnesota Surgical Technologist Program was developed as a direct result of the need for this specialized health care provider, expressed by the Twin Cities health care community. Saint Mary’s reserves the right to change or revise the program policies and procedures at any time without prior notice to the student. This handbook and related policies, procedures and information contained herein, supersede any and all prior oral or written representations or statements regarding the terms and conditions applicable to the students enrolled in the program.

This handbook is in addition to the policies and procedures set forth in the Saint Mary’s University of Minnesota Schools of Graduate and Professional Programs Catalog and Student Handbook. In cases where the program handbook and the SGPP Student Handbook have differing policies or procedures, the Surgical Technologist Handbook takes precedence. Viki Viertel, BS, CST

Program Director

Handbook Approved: Policy and Procedure Academic Committee 8/2013 Revised: August 2013

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Faculty

Saint Mary’s University of Minnesota

Schools of Graduate and Professional Programs Twin Cities Campus

2500 Park Avenue

Minneapolis, Minnesota 55404-4403 (612)728-5100

Fax – (612)728-5121

Web page: www.smumn.edu

Program Director Clinical Coordinator

Viki Viertel BS, CST Jay Bowman

LaSalle Hall Room 42 LaSalle Hall Room 42 612-728-5162 612-728-5166 vviertel@smumn.edu jbowman@smumn.edu Program Coordinator Veronica Murphy 612-728-5132 vmurphy@smumn.edu Core Faculty Dr. Kevin Swanson

Assistant Professor: Microbiology kswanson@smumn.edu

Jane O’Brien MA

Adjunct Instructor: Ethics obrien093@umn.edu

Tammi Gatchell CST

Adjunct Instructor: Core Curriculum tgatchell@smumn.edu

Karen Hecimovich CST

Adjunct Instructor: Core Curriculum keheci07@smumn.edu

Joel Dickey RN, CST

Adjunct Instructor: Pharmacology and

Medical Terminology joeldickey@google.com

Dean, Graduate School of Health and Human Services

Merri Moody CRNA, MS

Dean, Graduate School of Health and Human Services

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Affiliation Information

Surgical technologist students obtain clinical experience at various health care facilities throughout the Twin Cities to meet their clinical education requirements. These are:

Affiliation Sites

Abbott Northwestern Hospital

800 East 28th St.

Minneapolis, MN 55407 (612)863-4237

Fairview Southdale Medical Center

6401 France Ave. S. Edina, MN 55435 (952)924-5190

Children’s Hospital and Clinics

Minneapolis Campus 2525 Chicago Ave. S. Minneapolis, MN 55407 (612)813-6260

Fairview Sports Medicine

2450 Riverside Ave. Minneapolis, MN 55454 (612)273-6090

Children’s Hospitals and Clinics

St. Paul Campus 245 Smith Ave. St. Paul, MN 55102 (651)220-6236

Gillette Children’s Hospital

200 University Ave. E. St. Paul, MN 55101 (651)229-3864

Fairview Lakes Hospital

5200 Fairview Blvd. Wyoming, MN 55092 (651)982-7000

Mercy Medical Center

4050 Coon Rapids Blvd. Coon Rapids, MN 55433 (763)236-6700 Fairview Ridges 201 East Nicollet Blvd. Burnsville, MN 55337 (952)892-2080 Methodist Hospital 6500 Excelsior Blvd. St. Louis Park, MN 55426 (952)993-5370

Fairview-University Medical Center

Riverside Campus 2450 Riverside Ave. Minneapolis, MN 55454 (612)273-4080

Philips Eye Institute

2215 Park Ave.

Minneapolis, MN 55404 (612)775-8000

University of MN Medical Center

420 Delaware St. S.E. Minneapolis, MN 55455 (612)273-5343 Regions Hospital 640 Jackson St. St. Paul, MN 5510 (651)254-0000

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United Hospital

333 North Smith Ave. St. Paul, MN 55102 (651)241-8000

St. Francis Regional Medical Center

1455 St. Francis Ave. Shakopee, MN 55379-3380 (952)403-2302

Unity Hospital

550 Osborurne Rd. Fridley, MN 55432 (763)236-4006

TRIA Orthopedic Center

8100 Northland Dr. Bloomington, MN 55431 (952)831-8742

Veterans Administration Medical Center

One Veterans Dr. Minneapolis, MN 55417 (612)467-1748

Waconia Ridgeview Medical Center

500 South Maple St. Waconia, MN 55387 (952)442-2191

St. Johns Hospital

1575 Beam Avenue Maplewood, MN 55109-1169 (651) 232-7000

River Falls Area Hospital

1629 East Division St. River Falls, WI 54022 (715)425-6155

St. Joseph's Hospital

45 West 10th Street St Paul, MN 55102 (651)232-3000

Woodwinds Hospital

1925 Woodwinds Drive Woodbury, MN 55125 (651) 232-0228

Surgical Technology Program Outcomes:

Graduates of the Surgical Technology program are expected to be able to:

1. Integrate a comprehensive understanding of medical terminology into the practice of surgical technology

2. Apply a basic understanding of anatomy, physiology, pathophysiology, pharmacology, and microbiology to assisting with surgical procedures

3. Demonstrate proficiency in the application of aseptic technique in all aspects of the surgical care of patients

4. Demonstrate basic competence in the use of surgical instruments, supplies, and equipment used to provide patient care

5. Communicate effectively and respectfully with all members of the surgical team 6. Work effectively with a diverse population

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7 7. Demonstrate understanding of the ethical implications of personal actions

8. Acquire new knowledge through to participating in continuing education activities

Surgical Technology Grading Standards Academic Probation

Undergraduate students must maintain a minimum cumulative grade point average (GPA) of 2.0 within their current program. Undergraduate students whose cumulative GPA is below 2.0 are placed on academic probation.

To be removed from academic probation, students must raise their cumulative GPA to 2.0 (undergraduate) or above after the completion of six additional credits in the next semester within their current program. Students taking fewer than six credits will be removed from academic probation when they raise their cumulative GPA to 2.0 (undergraduate) or above with the first six credits completed in next semester(s). Failure to do so will result in

academic dismissal.

A student who receives a grade of “NC” in any course will be dismissed from the Surgical Technology Program.

Undergraduate students who have demonstrated academic deficiencies in academic performance or demonstrated deficiencies related to campus-wide outcomes that jeopardize the successful completion of their program will be placed on academic

probation. To be removed from probation they must successfully follow the provisions of an academic plan formulated by the student’s program director in conjunction with the dean and with input from faculty to address the deficiencies. Failure to complete any provision of the plan may result in academic dismissal.

Students must achieve 85% (B) or better in all clinical course. If a student has not achieved a minimum of 85% in any of the clinical courses, they will be dismissed. If a satisfactory grade is not achieved ST172 and ST252, the exams may be repeated once at the discretion of the instructor. The clinical courses include:

ST171 Operating Room Application I ST172 Skills Assessment I ST251 Operating Room Application II ST252 Skills Assessment II ST270 Clinical Practicum I ST280 Clinical Practicum II

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Surgical Technology Course Content Semester One:

Course Credits

ST105 Medical Terminology 1 credit per 15 hours.

ST110 Anatomy and Physiology 5 credits per 75 hours.

ST115 Introduction to Surgical Technology 3 credits per 45 hours.

ST120 Health Care Ethics 1 credit per 15 hours.

Semester Two:

ST150 Microbiology and Wound Healing 3 credits per 45 hours.

ST160 Pharmacology 4 credits per 60 hours.

ST170 Operating Room Principles I 3 credits per 45 hours. ST171 Operating Room Application I 4 credits per 60 hours.

ST172 Skills Assessment I 0 credits

Semester Three:

ST250 Operating Room Principles II 6 credits per 90 hours. ST251 Operating Room Application II 6 credits per 90 hours.

ST252 Skills Assessment II 0 Credits

Semester Four:

ST270 Clinical Practicum I 5 credits per 250 hours.

ST280 Clinical Practicum II 5 credits per 250 hours.

Total 46 Credits Semester One

ST105

Medical Terminology (1 credit per 15 hours)

This course is designed to provide the student with the skills necessary to identify, pronounce, spell, and use correct medical terminology.

Student Learning Objectives

Upon completion of this course, the student is expected to be able to: 1. Identify the organs and structures of human body systems.

2. Define the word roots and combining forms used to describe the organs and human body structures.

3. Define suffixes and prefixes in medical terminology.

4. Construct and define compound words as they relate to medical terminology. 5. Derive the meaning of new medical terms by analyzing their elements.

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ST110

Anatomy and Physiology (5 credits per 75 hours)

Following a systems approach, this course covers the organization and structure of the human body with emphasis on the physiologic function and interdependence of organ systems. Topics include the organization of the human body, cellular function, tissue classification, the

integumentary, skeletal, muscular, nervous, respiratory, digestive, urinary, lymphatic, reproductive, endocrine, immune, and circulatory system (both central and peripheral), the special senses, and blood and body fluids.

Student Learning Objectives

Upon completion of this course, the student is expected to be able to:

1. Identify body planes and demonstrate an understanding of body organization and biological terms of reference.

2. Describe the basic structure of the cell.

3. Identify the types and characteristics of tissue that comprise various organ systems. 4. Describe the layers of the skin and the components of each.

5. Locate, name, and describe the prominent features of bones, cartilage and joints. 6. Describe the characteristics of muscle tissue throughout the human body, with

emphasis on skeletal muscle and name the major external muscles of the body. 7. Explain the major anatomic and functional parts of the central, peripheral, and

autonomic nervous systems.

8. Define the function and structure of the organs making up the special senses, including the eye (sight), tongue (taste), nose (smell), skin (touch), and ear (hearing).

9. Describe the components and function of blood

10. Distinguish the anatomic structures of the heart and explain circulation of blood. 11. Describe the structure of arteries and veins; and name the major vessels of both

systems.

12. Identify the major structures comprising the lymphatic system and describe immunity. 13. Recognize the anatomical structures of the upper and lower respiratory tract, and

describe the regulatory mechanisms of the respiratory system.

14. Identify the structures and describe the function of the digestive system.

15. Identify and describe the structures, function and regulatory mechanisms of the urinary system.

16. Identify the structures and function of both the male and female reproductive system.

ST115

Introduction to Surgical Technology (3 credits per 45 hours)

This course provides the student with a broad background of today’s American health care industry and the role of health care providers with an emphasis on surgical technology. Specific topics include the history of the development of surgery as a medical specialty, health care delivery systems and facilities, hospital organization and management, introduction to the surgical team, the role and function of surgical technologists, and the ethical, moral, and legal responsibilities applicable to implementing standards of care. The course includes in-depth discussion of a patient’s emotional and physical response to illness and surgery. In addition the

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10 student is introduced to the physical layout of an operating room, including furniture, proper attire, and traffic patterns and to the chemical, biological, and physical hazards.

Student Learning Objectives

Upon completion of this course, the student is expected to be able to:

Unit I – The Health Care Industry

1. Describe the evolution of and the current forces impacting the delivery of health care in the United States, including accreditation and standard setting organizations. 2. Describe the financing of health care in the United States and its impact on the

Surgical Technologist.

3. Describe the nature and role of the American legal system and its traditional relationship to the health care industry.

4. Explain the relationship between standards of practice, position statements and the professional code of ethics.

Unit II – The Operating Room

5. Describe the roles of the surgical team and the Surgical Technologist professional role.

6. Explain the structure, organization and function of the surgical suite, including the multiple options in providing surgical services at various locations.

7. Identify effective strategies used to promote positive communication among health care professionals and with patients undergoing surgery.

8. Correctly name OR furniture and place each piece correctly

9. Identify possible hazards in the OR that are either physical, chemical, and/or biological

Unit III – The Surgical Patient

10. Correctly ascertain patient vital signs 11. Wash hands correctly

12. Determine the importance of the patient’s age and special health needs that affects their care in the OR

13. Describe the emotional impact that having surgery may have on patients

Unit IV – Getting the Patient Ready for Surgery

14. Describe the preoperative routine in preparing a patient for surgery 15. Describe the common procedures of determining surgical diagnosis. 16. Attain certification in CPR

ST120

Health Care Ethics (1 credit 15 hours)

This course presents ethical theories and conceptual framework that support ethical decision making. The Surgical Technologist Code of Ethics, ethical events that occur within the operative setting and professional responsibility in the delivery of safe, effective and competent patient care by the Surgical Technologist are presented.

Student Learning Objectives

Upon completion of this course, the student is expected to be able to:

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11 2. Describe the major ethical theories in terms of the principles of autonomy,

nonmaleficence, beneficence and justice.

3. Identify pertinent ethical issues facing the surgical technologist. 4. Define “surgical conscience.”

5. Identify issues and events that occur within the operative setting and can be affected by a surgical conscience.

6. Recognize events that may require an ethical analysis or a moral judgment in the perioperative area.

7. Identify the Surgical Technologist’s personal and professional responsibility in the delivery of safe, effective and competent patient care.

8. Describe the elements of the Surgical Technologist Code of Ethics.

Semester Two ST150

Microbiology and Wound Healing (3 credits per 45 hours)

This course addresses the structure and function of the cell, pathogenic and non-pathogenic organisms, microscopy and the microscope, classification of microorganisms, genetics, growth factors, and other characteristics of bacteria, microbes and the environment, nosocomial infections, prevention of disease transmission, the three lines of body defense mechanisms, sanitation, sterilization, and disinfection, wound healing, the infectious process and immune response. Allergy and hypersensitivity are addressed in terms of both patient and the surgical technologist. Special attention is paid to tissue reaction and restoration to normal functions following surgical trauma.

Student Learning Objectives

Upon completion of the course, the student is expected to be able to:

1. Identify the significant historical developments in the field of microbiology. 2. Describe theories of disease, including the germ theory.

3. Define common terminology used in the field of microbiology. 4. Understand the classification of microorganisms.

5. Describe the basic characteristics and diseases caused by the specific courses of microorganisms, including bacteria, fungi, viruses, protozoa, algae, and prions. 6. Describe basics of bacterial morphology, growth factors, and genetics.

7. Describe the interaction between man and microorganisms, including the indigenous microflora of the body.

8. Describe the disease process and pathogenicity and virulence factors.

9. Describe nosocomial infections, including contributing factors and prevention. 10. Describe the most common organism involved in nosocomial infections and other

organisms of concern to the surgical technologist.

11. Describe conditions that affect the growth of microorganisms.

12. Describe principles of decontamination, disinfection, and sterilization as they relate to surgical procedures.

13. Describe methods of sterilization, disinfection, and decontamination.

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12 15. Explain disease transmission and prevention, including the use of Standard Precautions

and other infection control practices.

16. Understand the non-specific and specific body defenses to infection, including the immune system.

17. Describe the basics of the healing process, including normal reactions and complications.

18. Describe the classification of wounds.

ST160

Pharmacology (4 credits per 60 hours)

Students review basic math skills and learn a framework of pharmacological principles in order to apply them in the surgical environment. Commonly used medication with surgical

applications are reviewed in depth including antibiotics, diagnostic agents, diuretics, drugs affecting the gastrointestinal system, hormones, drugs that affect coagulation, ophthalmic agents, preoperative medications anesthesia agents for general and regional techniques. Specific topics include basic math with emphasis on the metric system, percentages, and proportions; basic pharmacological principles including pharmacokinetics and

pharmacodynamics; drug administration routes and methods; blood and fluid usage; drug reactions including malignant hyperthermia; and, allergic reactions.

Student Learning Objectives

Upon completion of this course, the student is expected to be able to:

1. Demonstrate competence in using the metric system as applied to the science of pharmacology including measurement and weights, fractions and decimals, ratios and proportions, temperature measurement, liquid and solid calculations, and conversion values between measurement systems.

2. Describe basic pharmacological principles of drug action and effect in terms of the pharmocodynamic and pharmacokinetic properties of a drug.

3. Demonstrate the safe practice of drug identification, preparation and administration within the surgical environment.

4. Describe the legal requirements of drug preparation and administration within the surgical environment.

5. Describe the action, uses, and modes of administration and side effects of drugs used in the care of the surgical patient.

6. Describe the action, uses, modes of administration, and untoward effects of anesthetic and adjunctive agents used in the care of the surgical patient.

7. Describe the legal aspects and safety factors related to blood and fluid therapy.

ST170

Concurrent registration is required in ST171

Operating Room Principles I (3 credits per 45 hours.)

This course introduces the core principles of aseptic technique, sterilization and disinfection, the reprocessing of surgical instruments and supplies. Each student learns to perform a surgical scrub, don gowns and gloves, how to change gowns and gloves when contamination occurs, and how to gown and glove others. Patient transportation and patient positioning are both demonstrated and practiced. Preparation of the patient for surgical procedures is covered

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13 including urinary catheterization and skin preparation. The course also includes the principles of draping a patient and setting up a back table and Mayo stand. Basic instrumentation, sutures and surgical needles are covered. Related topics addressed are the methods of achieving hemostasis, care and handling of specimens, the appropriate response to emergencies resulting from blood volume emergencies, respiratory emergencies, cardiac emergencies, malignant hyperthermia, anaphylactic allergic reactions and seizures.

Student Learning Objectives

Upon completion of this course and learning laboratory, the student will be expected to: 1. Describe how infection control practices are implemented in the surgical setting to

ensure safe patient care.

2. Identify the basic principles of aseptic technique.

3. Describe the various means used to disinfect, sterilize and monitor surgical instruments and supplies for use in the OR.

4. Demonstrate the correct method of scrubbing, gowning, and gloving self and other members of the surgical team.

5. Demonstrate the proper methods to transfer and safely position the patient. 6. Describe and demonstrate the preparation of a sterile surgical field, including the

proper technique to maintain sterility when receiving or removing equipment and supplies from the field.

7. Describe the purpose and use of surgical drapes and demonstrate proper draping techniques for surgical equipment and the surgical patient for a variety of surgical procedures.

8. Correctly prepare and handle surgical supplies.

9. Identify basic surgical instruments by type, function and name and demonstrate the proper care, safe handling and assembly of surgical instruments. Classifications include: cutting, grasping, clamping, retracting, probing, suturing, scoping, dilating and

dissecting.

10. Identify suture materials and demonstrate proper preparation and handling techniques. 11. Demonstrate correct handling of needles and syringes.

12. Describe common means of establishing hemostasis. 13. Demonstrate the proper care of handling of specimens

14. Describe the role of surgical technologist in responding to life-threatening emergencies in the OR.

ST171

Concurrent registration is required in ST170

Operating Room Application I (4 credits per 60 hours.)

This course is designed to augment the classroom theory presented in ST170. It provides the student with the opportunity to repeatedly scrub, gown and glove themselves and others, reprocess surgical supplies, activate the flash sterilization cycle, drape and set up a back table and Mayo stand with instruments and basic supplies appropriate for a laparotomy procedure, accept and label medications, drape a patient and take down the drapes and instruments following the conclusion of a procedure. Passing of the Skills Assessment of basic competence of aseptic technique, the setting up of a Mayo stand and back table, and draping of the patient is required.

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Student Learning Objectives

Upon completion of this course, the student is expected to be able to:

1. Demonstrate the correct method of performing a surgical scrub, donning sterile gown and gloves of self and other surgical team members.

2. Drape and correctly prepare a back table and Mayo stand in preparation for a simple laparotomy procedure, including, basic instruments, sutures, and drapes.

3. Accept and correctly place sterile surgical supplies. 4. Accept and correctly label medications.

5. Place sterile drapes correctly and efficiently. 6. Perform correct surgical counts.

7. Demonstrate aseptic technique including awareness of breaks in technique, proper and efficient correction of breaks, openness to being informed of breaks in technique, and professional manner in informing others of breaks in technique.

ST172

Concurrent registration is required in ST170 and ST171

Skills Assessment I (0 credits)

This course is an exam that assesses the demonstration of the clinical skills necessary in order to proceed into ST250 and ST251.

Student Learning Objectives

Upon completion of this course, the student is expected to be able to:

1. Demonstrate the correct method of performing a surgical scrub, donning sterile gown and gloves of self and other surgical team members.

2. Drape and correctly prepare a back table and mayo stand in preparation for a simple laparotomy procedure, including, basic instruments, sutures, and drapes

3. Accept and correctly place sterile surgical supplies 4. Accept and correctly label medications

5. Place sterile drapes correctly and efficiently 6. Perform correct surgical counts

7. Demonstrate aseptic technique including awareness of breaks in technique, proper and efficient correction of breaks, openness to being informed of breaks in technique, and professional manner in informing others of breaks in technique

Semester Three ST250

Concurrent registration is required in ST251

Operating Room Principles III (6 credits 90 hours.)

This course reviews the pertinent anatomy, physiology, and common pathophysiology related to: general procedures, obstetrics and gynecological procedures, orthopedics, ENT,

ophthalmology, neurological procedures, cardiothoracic and peripheral vascular surgery, urologic, maxillofacial, plastic, and pediatric procedures. Conditions that warrant surgical correction are discussed in depth. Common specialized instruments by type, function, name, and supplies are discussed in the context of each specialty. Common procedures in each of the

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15 surgical specialty areas are explained in detail including indication for surgery, anatomy

involved, anticipated incision, patient position and prepping, draping, and step-by-step explanation of the procedure. This course is coordinated with the content of ST251.

Student Learning Objectives

Upon completion of this course, the student is expected to be able to: Discuss these critical surgical aspects associated with the following: 1. The relevant anatomy related to the surgical systems

2. Common surgical pathophysiology of the surgical systems

3. Indications for, the purposes of, the expected outcomes, and possible complications related to the surgical systems

4. Identify common specialized surgical instruments by type, function and name related to the surgical systems

5. Explain how to use specialized supplies and equipment related to the surgical systems: a. General surgery

b. Obstetric and gynecological surgery c. Ear, nose and throat surgery

d. Head and Neck, Oral and maxillofacial surgery e. Orthopedic surgery

f. Plastic and reconstructive surgery g. Neuro and spine surgery

h. Peripheral vascular surgery i. Genitourinary surgery j. Cardiothoracic surgery k. Ophthalmic surgery l. Pediatric Surgery

ST251

Prerequisite: Grade of 85% (B) or better in ST171 Concurrent registration is required in ST250

Operating Room Application II (6 credits per 90 hours.)

This course provides the clinical environment in which to practice the theories and skills covered in ST250. Students have repeated opportunities to scrub, gown and glove themselves and others, drape and set up a Mayo stand and back table appropriate for general laparotomy, gynecological, orthopedic, ENT, and laparoscopic procedures. Each student learns to handle instruments, suture and needles and sterile supplies. Progress of skill mastery is assessed and evaluated by return demonstration methods. Passing of the Skills Assessment of aseptic technique, the setting up of a Mayo stand and back table, draping of the patient, handing and receiving supplies, surgical instruments, suture, and needles, is required.

Student Learning Objectives

Upon completion of this course, the student is expected to be able to:

1. Demonstrate the preparation of a sterile surgical field, including the proper technique to maintain sterility when receiving or removing equipment and supplies from the field. 2. Demonstrate the preparation of sterile supplies and equipment.

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16 3. Demonstrate intraoperative techniques for the safe handling and passing of

instrumentation.

4. Describe the purpose and use of surgical drapes.

5. Anticipate appropriate instrumentation needs as demonstrated by Mayo stand and back table set up.

6. Select, prepare and safely pass appropriate surgical suture materials.

7. Demonstrate the proper set up of a sterile field, correct instrumentation and

equipment, correct draping techniques for an exploratory laparotomy, D&C, T&A, ORIF, and laparoscopic cholecystectomy.

8. Identify the safe use, basic care, handling and cleaning techniques of suction and vacuum systems, lights, pneumatic equipment, tables and other OR furniture. 9. Pass the required skills proficiency exam with a minimum of 85%.

ST252 Skills Assessment II

This course is an exam that assesses the demonstration of the clinical skills necessary in order to proceed into ST270/ST280 Clinical Practicum.

Student Learning Objectives

Upon completion of this course, the student is expected to be able to:

1. Demonstrate the correct method of performing a surgical scrub, donning sterile gown and gloves of self and other surgical team members.

2. Drape and correctly prepare a back table and mayo stand in preparation for all of the five basic procedures, including, basic instruments, sutures, and drapes in less than 20 minutes 3. Open and accept surgical supplies.

4. Accept and correctly label medications, also perform a “pause for the cause” to identify the patient

5. Apply sterile drapes correctly and efficiently

6. Initiate and complete surgical counts for all of the basic procedures. 7. Pass surgical instruments for all five of the basic surgical procedures.

8. Handle sharps in a safe and effective manner, dispose of sharps and hazardous materials appropriately.

9. Remove drapes from the patient and remove their gown and gloves and dispose of this material properly.

10. Demonstrate aseptic technique including awareness of breaks in technique, proper and efficient correction of breaks, openness to being informed of breaks in technique, and professional manner in informing others of breaks in technique

Semester Four ST270

Prerequisite: Grade of 85% (B) or better in ST251

Clinical Practicum I (5 credits/250 hours.)

Students are assigned to a clinical facility and assist with surgical procedures within the operative setting under the personal supervision of a clinical preceptor. This practicum is designed for the student to integrate knowledge and theory from previous courses and to

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17 develop specific psycho-motor skills as a surgical technologist. Clinical assignments are based on a set of clinical performance objectives that must be met prior to the completion of the semester. During this course, the student follows a patient through the entire perioperative experience from preoperative preparation, through the OR and postop recovery. Students participate in bi-weekly clinical conferences to debrief current learning and synthesize

knowledge with practice. Also covered in these bi-weekly sessions are professional topics such as understanding the roles, responsibilities and variety of personalities that comprise OR settings, the development of a resume and cover letter, and completion of an application form for employment.

Student Learning Objectives

Upon completion of this course, the student is expected to be able to: 1. Identify the roles and responsibilities of the surgical technologist.

2. Explain the ethical, legal and moral aspects of surgical technology as they relate to patients, co-workers, employers, communities and self.

3. Use appropriate medical terminology, accurately and with ease.

4. Relate principles of human anatomy, physiology and pathophysiology to a wide variety of surgical conditions and procedures.

5. Identify the surgical instrumentation and supply needs for a wide variety of surgical conditions and procedures.

6. Apply principles of microbiology in maintaining asepsis.

7. Protect patients, staff and self from iatrogenic complications by the consistent use of standard precautions and other safety measures as appropriate.

8. Prepare, calculate, and label drugs and solutions accurately.

9. Identify critical components necessary to prepare the patient for surgery; including patient identification, consent for surgery, preoperative laboratory requirements and results, physical assessment and vital signs, patient transport, patient positioning, skin preparation requirements, urinary catheterization, emergency preparations and cardiopulmonary resuscitation.

10. Demonstrate methods of sterilization and disinfection, including room preparation and terminal cleaning of equipment and supplies.

11. Prepare equipment and supplies for surgical use. 12. Safely select and pass surgical instruments.

13. Demonstrate personal and professional integrity and the ability to interact as a professional with the entire health care/surgical team.

14. Complete the required clinical experience documentation. 15. Prepare a personal resume and cover letter.

ST280

Prerequisite: Grade of 85% (B) or better in ST270

Clinical Practicum II (5 credits/250 hours)

In this course, the student continues to assume a role with greater responsibility on the surgical team at a different clinical facility than the first rotation. Specialty procedures are scheduled as part of the student’s learning opportunities. Students may have the opportunity to obtain experience in areas outside of the main operating room, such as labor and delivery, the instrument room, special procedures area, the outpatient setting, and other procedure areas.

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18 The student demonstrates clinical proficiency to an employment-acceptable level in general and commonly performed specialty procedures. Bi-weekly clinical conference days continue for debriefing of the clinical experience, professional development, and a simulated interview situation. The student will sit for the National Board for Surgical Technology and Surgical Assisting (NBSTSA) the last day of the program.

Student Learning Objectives:

Upon completion of this course, the student is expected to:

1. Identify the appropriate roles and responsibilities of the surgical technologist. 2. Explain the ethical, legal and moral aspects of surgical technology as they relate to

patients, co-workers, employers, communities and self.

3. Use appropriate medical terminology accurately and with ease.

4. Relate principles of human anatomy, physiology and pathophysiology to a wide variety of surgical conditions and procedures.

5. Identify the surgical instrumentation and supply needs for a wide variety of surgical conditions and procedures.

6. Apply principles of microbiology in maintaining asepsis.

7. Protect patients, staff and self from iatrogenic complications by the consistent use of standard precautions and other safety measures as appropriate.

8. Recognize the action and indication of drugs used in the surgical environment. Prepare and calculate drugs and solutions as necessary

9. Demonstrate knowledge of a wide variety of anesthetic drugs and techniques. 10. Identify critical components necessary to prepare the patient for surgery, including

patient identification, consent for surgery, preoperative laboratory requirements and results, physical assessment and vital signs, patient transport, patient positioning, skin preparation requirements, urinary catheterization, emergency preparations and cardiopulmonary resuscitation.

11. Document the care of the patient as defined by legal and institutional policy.

12. Demonstrate methods of sterilization and disinfection, including room preparation and terminal cleaning of equipment and supplies.

13. Demonstrate personal and professional integrity and the ability to interact as a professional with the entire health care/surgical team.

14. Complete the required clinical experience documentation, including types and numbers of cases scrubbed, role of first scrub or assist, daily performance evaluation, daily care plan.

15. Practice interviewing for a job.

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19

SURGICAL TECHNOLOGY CASE MINIMUM REQUIREMENTS

At the completion of Clinical Practicum I and II, students must meet or exceed the minimum case requirements outlined as follows:

SURGICAL ROTATION MINIMUM CASE REQUIREMENTS

Surgical specialty Total # cases required

Minimum # of First Scrub Cases

Required

Maximum # of Second Scrub Cases that Can be Applied Towards 120 Cases General Surgery 30 30 10 Surgical Specialties Cardiothoracic ENT Eye GU Neuro Ob-Gyn Oral/maxillofacial Orthopedics Peripheral vascular Plastics Procurement/Transplant 90 60 30

Labor and Delivery

5 vaginal delivery cases may be applied toward the second scrub cases

Diagnostic Endoscopy Bronchoscopy Colonoscopy Cystoscopy EGD ERCP Esophagoscopy Laryngoscopy Panendoscopy Sinuscopy Uteroscopy 10 diagnostic endoscopy cases may be applied toward the second scrub cases

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20 1. The total number of cases the student must complete is 120.

2. Students are required to complete 30 cases in General Surgery. Twenty of the cases must be in the First Scrub Role.

3. Students are required to complete 90 cases in various surgical specialties. Sixty of the cases must be in the First Scrub Role and evenly distributed between a

minimum of 5 surgical specialties. However, 15 is the maximum number of cases that can be counted in any one surgical specialty.

4. The surgical technology program is required to verify through the surgical rotation documentation the students' progression in First and Second Scrubbing surgical procedures of increased complexity as he/she moves towards entry- level graduate abilities.

5. Diagnostic endoscopy cases and vaginal delivery cases are not mandatory. But up to 10 diagnostic endoscopic cases and 5 vaginal delivery cases can be counted towards maximum number of Second Scrub Role cases.

6. Observation cases must be documented, but do not count towards the 120 required cases.

7. Counting Cases

Cases will be counted according to surgical specialty. Examples:

• Trauma patient requires a splenectomy and repair of a LeFort I fracture. Two cases can be counted and documented since the splenectomy is general surgery specialty and repair of LeFort I is oral-maxillofacial surgical specialty.

• Patient requires a breast biopsy followed by mastectomy. It is one pathology, breast cancer, and the specialty is general surgery; therefore, it is counted and documented as one procedure one case.

FIRST AND SECOND SCRUB ROLE AND OBSERVATION

FIRST SCRUB ROLE

The student surgical technologist shall perform the following duties during any given surgical procedure with proficiency. The following list is provided to identify the items that must be completed in order to document a case in the first scrub role. A student not meeting the five criteria below cannot count the case in the first scrub role and the case must be documented in the second scrub role or observation role.

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21

• Verify supplies and equipment needed for the surgical procedure.

• Set up the sterile field with instruments, supplies, equipment, medication(s) and solutions needed for the procedure.

• Perform counts with the circulator prior to the procedure and before the incision is closed.

• Pass instruments and supplies to the sterile surgical team members during the procedure.

• Maintain sterile technique as measured by recognized breaks in technique and demonstrate knowledge of how to correct with appropriate technique. SECOND SCRUB ROLE

The second scrub role is defined as the student who is at the sterile field who has not met all criteria for the first scrub role, but actively participates in the surgical procedure in its entirety by completing any of the following:

• Sponging

• Suctioning

• Cutting suture

• Holding retractors

• Manipulating endoscopic camera OBSERVATION ROLE

The observation role is defined as the student who is in the operating room performing roles that do not meet the criteria for the first or second scrub role. These

observation cases are not to be included in the required case count, but must be documented by the program.

Graduation requirements

Surgical Technology students must meet and fulfill all academic and clinical requirements for the program in order to be eligible for graduation.

1. Students must be in good standing academically.

2. Students must achieve 85% (B) or better in all clinical course. The clinical courses include: ST171 Operating Room Application I

ST251 Operating Room Application II ST270 Clinical Practicum I

ST280 Clinical Practicum II

3. Students must pass the following Skills Assessments with 85% or better ST172 Skills Assessment I

ST252 Skills Assessment II

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22 Examination offered on the last day of the program at Saint Mary’s University of MN.

Academic and Clinical Evaluation

Academic course work is evaluated according to the individual course syllabi. Grade point average and academic standing are governed by university policy as outlined in the current copy of the Schools of Graduate and Professional Programs Catalog and Student Handbook. The student’s clinical performance is evaluated according to predetermined performance criteria, designed to demonstrate growth and integration of knowledge and skill required of the entry level Surgical Technologist in two areas of learning:

1. Didactic courses 2. Clinical Courses

If a student fails to meet the criteria in any of the above areas, the instructor(s), and program director will meet with the student to discuss an appropriate Student Performance Plan to be developed and implemented. Failure to meet the performance goals stated within the time agreed to may result in the student’s dismissal from the program.

Students will have the opportunity to participate in course/instructor evaluations. Students will also complete a clinical site and clinical instructor evaluation process as part of their clinical experience.

Surgical Technology Class and Clinical Attendance Policy

Students are expected to attend all class sessions, clinical application labs and clinical practicum days. Tardiness and/or leaving early is not acceptable professional behavior. Any absence must be approved with the course instructor and the program director. Failure to contact the course instructor and the program director in advance will result in an unexcused absence. An

unexcused absence may result in the student being dismissed from the program.

Unexcused absences may include but are not limited to:

1. Tardiness or leaving early. It is the expectation that students will be on time for all courses and clinical experiences. Tardiness and/or leaving early in excess of two times per class and/or clinical will be considered an unexcused absence.

2. Not prearranging an absence with faculty/Program Director. If an absence is unavoidable, it is the responsibility of the student to contact the course instructor, and program director in advance of the class or clinical day. Regardless of why a class is missed, the student is responsible for the material covered. Additional work may be assigned by the instructor. 3. If a quiz/test is missed due to an excused absence, the student will need to make-up the

quiz/test before the next scheduled class or the points will be forfeited. Students must make these arrangements with the program administrative staff. Any quizzes and/or tests that are missed due to an unexcused absence will not be offered for make-up.

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23

Clinical Practicum

If a student misses a clinical practicum day, for any reason, the entire day will need to be made up on his/her own time. It is the student’s responsibility to arrange the make-up day with the OR clinical educator and/or the OR manager at the participating clinical site which must be pre- approved by the Program Director. All days must be made-up to meet the requirements for graduation established by the Association of Surgical Technology (AST).

In the event of an absence the student must inform the following:

1. The clinical site control desk. Make sure you speak to a HUC, secretary, and/or charge nurse. Do not leave a voice-mail message.

2. Clinical Instructor

3. The Surgical Technology Program Director and/or Program Coordinator

If the student is late or leaves early, he/she will need to make up the missed time in agreement with the OR clinical educator and/or the OR manager. Leaving early without the permission of the OR clinical educator and/or the OR manager is not acceptable and will be considered an unexcused absence.

Homework

All assigned homework is due on the date specified on each syllabus. All homework is due at the beginning of the class. Handing homework in late, including at the end of the class, will result in a reduction of 50% of the points. Homework received later than one week will result in no credit. Any changes in the homework due date is up to the faculty. Any exceptions must be negotiated with the individual faculty well before the due date.

Student Health Status Policy

All students are required to demonstrate the ability to physically complete the rigors of the program. An appropriate licensed health care provider on the form provided by the university must document this. In addition, the student’s immunization status must positively indicate immunity to:

a. Rubella (German or Three Day Measles) b. Measles (Rubeola or Regular Measles) c. Mumps

d. Varicella (Chickenpox) e. Tetanus

f. Two-step Mantoux Tuberculin (TB) skin test

Results will be maintained in the student file and a copy sent to the host hospital before each rotation of the Clinical Practicum.

Students are advised to complete a Hepatitis B vaccination program.

Students who are pregnant, become pregnant, or who are considering pregnancy during the program MUST notify the Program Director immediately. The unique hazards found in the Operating Room place pregnant women at risk for certain complications.

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Student Illness

The patient’s safety is of prime importance in the surgical environment. Students who are ill place the patient and other co-workers at risk and are therefore advised to remain out of the academic and clinical areas, until that illness is resolved. (See attendance policy.) Students who have had the following conditions may not return to the clinical site without a physician’s statement. These include:

a. Any work-related injury or illness b. All orthopedic or back problems c. Any surgical procedure

d. Any mental health issues and/or chemical dependency issues e. Health-related absences greater than one week

f. Infectious diseases, such as: 1. Hepatitis

2. Lice

3. Tuberculosis 4. Scabies 5. Hand lesions

6. Diarrhea over three days 7. Conjunctivitis

8. Non-allergic skin rashes 9. Shingles, or

10. Exposure to a childhood disease such as mumps

Clinical Affiliation sites

Clinical affiliation sites are designed to provide the Surgical Technologist student with a wide variety of experience and the opportunity for the student to integrate classroom theory with actual clinical experience. Each site presents a different perspective in terms of providing care to the surgical patient. Each site may have different policies and procedures that affect the delivery of patient care. The Surgical Technologist student is responsible for knowing, understanding and complying with affiliate site policies and procedures.

Student assignment to a particular clinical site will be determined based on the learning needs of the student and the capabilities of an individual clinical site. Students will be assigned to a second clinical site in ST280 to expand the student knowledge of Operating Rooms.

Student Work Policy

Surgical Technology students may never be substituted for paid personnel to conduct the work of the clinical facility. However, after demonstrating proficiency, students may be permitted to undertake certain defined activities with appropriate supervision and direction.

This statement reflects the accreditation requirements of AST/CAAHEP

Student Behavior

As members of a Lasallian community of scholars, students are expected to adhere to the highest levels of ethics and professionalism in all interactions with other members of the

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25 university community. In cases where a student’s behavior is not professional or is disrespectful toward others within the university community, the student may be subject to disciplinary action, possibly dismissal from the program. For additional information, please consult the Saint Mary’s University of Minnesota Catalog and Student Handbook 2013-2015.

Unsafe and Unprofessional Clinical Practice Defined

Unsafe clinical practices are behaviors demonstrated by the student that threaten or violate the physical, biological, or emotional safety of the patient assigned to his/her care.

The following examples serve as guidelines for unsafe clinical practices.

PHYSICAL SAFETY: unsafe behaviors including inappropriate use of side rails, wheelchairs, positioning straps and equipment, lack of proper protection of the patient which increases the risk for falls, lacerations, burns, etc. Students are not permitted to exceed the Scope of Practice of a Surgical Technologist with actions such as placing retractors, cutting tissue, cauterizing tissue, suturing any tissue, or closing incisions. Hospital employee preceptors must be scrubbed in or in the room with the student according to individual hospital policy.

BIOLOGICAL SAFETY: unsafe behaviors including failure to recognize errors in aseptic technique, failure to acknowledge attending the clinical site while ill.

EMOTIONAL SAFETY: unsafe behaviors including threatening patients or causing the patient to be fearful, providing patients with inappropriate or incorrect information or failure to seek help when needed. Other unsafe behaviors include demonstration of unstable emotional behaviors, unprofessional behaviors demonstrated by the student that are inappropriate to the student- instructor, student-hospital-personnel, student-physician or student-patient interactions which may be taken to be unsafe practice or reflect negatively upon the Surgical Technology program or Saint Mary's University of Minnesota.

The following examples serve as guidelines for unprofessional practice: inappropriate verbal or non-verbal language, actions, or voice inflection which compromise rapport or working

relations with patients, family members of patients, staff, physicians, or instructors which may compromise contractual agreements and/or working relations with clinical affiliates, or

constitute violations of legal or ethical standards.

This statement reflects the accreditation requirements of AST Core Curriculum

Hazardous Material/Exposure to Blood or Body Fluids

While the continuous use of Standard Precautions and other safety measures may limit the student’s risk to exposure of blood or body fluids, the surgical environment is not free from risk. Safety must be a primary goal in the clinical learning area. To help meet this goal, the student will be orientated to the safety policies and procedures of each clinical site.

If the student experiences exposure to blood or body fluids, the student must report the exposure immediately to the preceptor, the OR leadership, the clinical instructor, and the

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26 program director. The student’s exposure will be evaluated as to severity and the clinical site’s policy will be followed. The clinical site may provide emergency care. The student is

responsible for all costs related to treatment or follow-up.

The student must notify the program of the exposure incident treatment by filling out the Hazardous Material/Exposure to Blood or Bodily Fluids form prior to return to the clinical area. If the exposure was due to failure to adhere to institutional/program policies, the student may be disciplined.

Student Health Insurance

Saint Mary’s University of Minnesota offers students the option of obtaining health insurance. To be eligible for coverage, students must be registered in at least three credits at the time of enrollment in the program. Contact Student Services for more information.

Professional Liability Insurance

Students enrolled in the Surgical Technologist program are required to carry professional liability insurance with the minimum of $1,000,000 per incident/$3,000,000 aggregate coverage. The program will purchase and maintain professional liability through the MARSH Affinity group, underwritten by Seabury and Smith. Liability is purchased annually with the Semester Fee.

Verification will be maintained in the student file and a copy sent to the host hospital before each rotation of the Clinical Practicum.

Criminal Background Studies

Surgical technology students work with vulnerable persons as defined by the Minnesota Vulnerable Adults Act of 1995 and Wisconsin 1997, Act 27 and 1999 Act 9. In order to be in compliance with this legislation, criminal background studies must be submitted by all students once per year and as required by Wisconsin affiliates. Failure to be cleared by either Minnesota or Wisconsin may result in dismissal from the surgical technology program.

Certification in Basic Life Support/CPR

Certification in the American Heart Association Basic Life Support/CPR will be offered during the first semester and will be current for two years to include the Clinical Practicum. This certification is mandatory whether the student is currently certified by another source. The results will be maintained in the student file and a copy sent to the host hospital before each rotation of the Clinical Practicum.

Policy Concerning Unanticipated Patient Events/Outcomes

If a student becomes aware of an unexpected patient event, patient or student accident, mishap or poor outcome, the student must notify his/her clinical instructor, the program director, and follow all hospital procedures. The program director will notify the insurance carrier. Failure to follow this policy may result in a refusal to provide coverage by the student’s insurance carrier. It may also result in discipline against the student.

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Supervision of Student Surgical Technologists

The Surgical Technology student must always be under the direct supervision of a clinical preceptor/instructor. Students must identify their student status to all the members of the Surgical Team whenever they are in the clinical area.

Parking/Transportation

Students are responsible for their own transportation to and from classroom and clinical sites. Students should be aware that parking at some clinical sites could be problematic and carry a fee.

Students are also reminded that the Twin Cities is an urban environment and that personal safety should be a concern for all, no matter where parking is available. Students should be aware of their surroundings at all times, use a security escort if necessary and report all suspicious activity to the appropriate authorities.

Identification Badges

Health care facility security measures require that students be identified at all times. Individual identification badges will be issued to students and must be displayed in the proper manner at all times.

Dress Code

1. Each student must wear a Saint Mary’s Surgical Technology identification badge or identification issued by an individual hospital while at clinical sites.

2. Each student must wear appropriate, professional dress to and from the clinical site. 3. A pair of comfortable and safe shoes should be purchased for use in the OR only. 4. Protective eyewear must be worn on all surgical procedures. False eyelashes are

prohibited.

5. Artificial fingernails are prohibited. Fingernails should be short and unpolished.

6. Hair should be secured in such a manner that prohibits extension beyond surgical headgear. 7. Good personal hygiene is mandatory for the surgical technologist.

8. Any visible jewelry is not allowed on the clinical site during the lab experience and/or clinical practicum.

Semester Fee

A Semester Fee that covers individual expenses associated with the program and other miscellaneous program expenses will be assessed each semester. This fee is nonrefundable.

Statement of Student Rights and Responsibilities

Saint Mary’s will provide the student with the academic and clinical opportunities that lead to the development of the basic minimum competencies for the entry level Surgical Technologist.

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Students have the right to expect that:

1. They will not be exploited relative to time commitment for pay or profit in the clinical setting in accordance with the policy of the Association of Surgical Technology. 2. Student evaluations will be fair and accurate descriptions of their progress. 3. Students will have access to their academic records in accordance with the Family

Educational Rights and Privacy Act (FERPA) as described in the Saint Mary’s University of Minnesota Schools of Graduate and Professional Programs Catalog and Student Handbook.

Students will be held accountable for:

1. The quality of the preparation, completion and performance of their academic work. 2. Complying with the policies of Saint Mary's University of MN and the Surgical Technology

Program.

3. The progress of their clinical performance.

4. Failure to maintain academic, clinical performance levels, attendance or punctuality standards may result in dismissal from the program.

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Saint Mary’s University of Minnesota Schools of Graduate and Professional Programs Surgical

Technology Program

Hazardous Material/Exposure to Blood or Bodily Fluids

Student: Date:

I understand that I have been or may have been exposed to possible hazardous body fluids. It would be in my best interest to see a physician. However, I understand that it is my right to refuse to see a physician.

I assume all risks associated with exposure to possible hazardous bodily fluids. I hereby release Saint Mary's University of Minnesota (the University), its agents and employees, the hospital and/or clinical site, the patient and other students from any and all damages, claims, and causes of action whatsoever for any loss or injury suffered by me from the exposure, including any damages, claims or causes of action which may result from the negligence of the University, its agents or employees. I agree to save and hold harmless the University, its agents and

employees from any claim by me or my estate arising out of my exposure to possible hazardous bodily fluids. I intend by this instrument to exempt and release the University, its agents and employees from all liability whatsoever for personal injury, property damage, or wrongful death caused by its negligence and associated with the exposure. This release shall be binding on upon my heirs, administrators, executors, and assigns.

Description of event:

Site: Time: Preceptor:

Describe event in detail:

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Student Performance Plan

To: From:

Re: Student Performance Plan

This statement is to acknowledge that I have met with , the Surgical

Technology Program Director, and to discuss the following:

1. 2. 3.

My goals to correct the above are: 1.

2. 3.

I understand that the above stated goals must reach an acceptable level by the following date:

to continue in the program.

Student Date

Faculty Date

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Acknowledgement of Surgical Technology Handbook

I affirm that I have had sufficient orientation to the policies and procedures of Saint Mary’s University of Minnesota Surgical Technologist program. During orientation to the program, I received adequate knowledge of my rights, responsibilities, relationships and lines of

communication.

I understand that some of these policies may change during the course of the program and that I will be made aware of these changes by the program.

I also understand that this document is not a contract.

Printed Name

Student Signature

References

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